Flashcards in Triage and MBS Deck (20):
What are the main components of assessing the emergency patient?
Triage (urgency and severity of the problem n.b. ABCs are a component of triage)
ABCs (airways, breathing, circulation)
What should be treated as an emergency?
Anything the owner thinks is an emergency! Including conditions that are life threatening or trivial!
How are ABCs assessed?
Airway - is there a patent airway?
Breathing - Is the patient making useful breathing efforts?
Circulation - Is there a heart beat with pulses?
What comprises the capsule history?
Age, breed, sex
Appetite, water intake, activity level
What things are checked as part of the CVS assessment?
Capillary refill time
What changes do variations in pulses indicate? Give detail on what specifically the variations in pulse amplitude and width mean.
Compensatory changes to vasoconstriction in the CVS in response to reduced peripheral perfusion.
Amplitude indicates difference in systolic and diastolic pressure. Bigger difference = higher amplitude
Width=duration of heart beat
What may complicate a pulse assessment?
A fracticious animal
Obesity and heavy muscling
What should happen to an animals pulse if it was previously poor and then placed on fluids? And what would need to be done if this was not the case?
It should return to a normal amplitude/quality
If not then an underlying cause of hypovolaemia should be investigated.
How do changes in HR, MM colour, CRT, pulse amplitude and duration vary as hypovolaemic shock progress from mild to severe?
As hypovolaemic shock progresses from mild to severe the CRT gets longer even though HR is increased. Pulse quality also declines although the mild patient may have an increased pulse amplitude.
What should one bear in mind when evaluating the respiratory system with regards to critical animals?
Testing can be fatal - esp. to cats. So need to weigh risks against benefits.
How is the resp system assessed?
Watch effort and rate from a distance .
Listen from afar for audible noise
Listen with stethoscope to localise abnormal noises.
What are the components of the respiratory system that can be assessed?
Chest wall and diaphragm
What does a normal resp effort present like?
Little chest movement
No audible noise (breed dependent)
Chest and abdomen move out together
Increased effort = increased chest sounds
How do postural changes in response to dyspnoea in the dog and cat vary?
Both will extend their neck and open mouth breath (severe)
Dog may abduct elbows whilst the cat prefers sternal recumbency
There may be an anxious look, increased abdominal effort or paradoxical abdominal movement
Cyanosis may be present
Lateral recumbancy is extremely bad (esp. cats!!!)
What is paradoxical abdominal movement?
When the abdomen moves in whilst the chest moves out.
What is the difference between obtunded and stuporous animals?
Obtunded = depressed/dull but rousable
Stuporous = only rousable by painful stimuli
How does the rest of an MBS(or indeed, general assessment) relate to the neurologic assessment?
The degree of mentation should be considered in light of other findings e.g. BGs, drugs and hypoperfusion. Gait abnormalities should also be considered in this sense.
What is assessed at the end of an MBS and what is one looking for/determining?
Abdominal palpation - look for pain/distension
Body temperature - pyrexia vs hyperthermia
What else might be useful to assess?
PCV, total protein, blood glucose! Venous blood gas/electrolytes.